Related Experiment Video
Updated: Jun 23, 2026
05:52
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Thrombolysis in young adults with ischemic stroke
Jukka Putaala1, Tiina M Metso, Antti J Metso
1Department of Neurology, Helsinki University Central Hospital, Haartmaninkatu 4, FIN-00290, Helsinki, Finland. jukka.putaala@hus.fi
Stroke
|April 18, 2009
Summary
Young adults with ischemic stroke show improved outcomes with thrombolytic treatment. Intravenous alteplase demonstrated good safety and efficacy in this patient group.
Area of Science:
- Neurology
- Vascular Neurology
- Emergency Medicine
Background:
- Limited data exist on thrombolytic treatment safety and outcomes in young patients with ischemic stroke.
- Ischemic stroke in young adults presents unique challenges and requires specific treatment considerations.
Purpose of the Study:
- To evaluate the safety and outcomes of intravenous thrombolysis with alteplase in young patients (16-49 years) with acute hemispheric ischemic stroke.
- To compare outcomes and hemorrhage rates between young alteplase-treated patients and matched control groups.
Main Methods:
- Retrospective analysis of 48 young patients treated with intravenous alteplase for ischemic stroke.
- Comparison with 96 age- and gender-matched controls not receiving alteplase.
- Comparison with 96 older alteplase-treated patients matched for gender and stroke severity.
Main Results:
- Young alteplase-treated patients had significantly better complete recovery (27% vs. 10%) and favorable outcomes (40% vs. 22%) compared to untreated controls.
- No symptomatic intracerebral hemorrhage was observed in young alteplase-treated patients, versus 3% in older controls.
- Mortality was 0% in young alteplase-treated patients during the 3-month follow-up.
Conclusions:
- Intravenous thrombolysis with alteplase is safe and effective for young adults with acute hemispheric ischemic stroke.
- Younger patients appear to benefit more from thrombolysis compared to older counterparts.
- Thrombolytic therapy should be considered in the management of ischemic stroke in young adults.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
01:16Clot Retraction and Fibrinolysis
After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...